My lexapro diary

[jonjon]

Got to work today and did all my tasks. Anxiety still present. By the afternoon I was totally wiped out. Namely tired and trouble concentrating. I took a 2mg Valium and had a rest and feel a bit better this evening.

Am having some stomach pains since going to 10mg. Nothing too serious but definitely noticeable.

Also had my second Pfizer covid injection yesterday so that might have contributed to my feeling crap today.

Lets hope next week gets better.

[Phill2]

Well done at work
It will get better
Just give it time

[jonjon]

So today was pretty awful. Anxiety and headaches all day long. Spent most of the day on the couch. Took 2mg Valium before dinner.

Yesterday I actually had a good day and was quite productive so I was hopeful that I was turning a corner.

I think it is my 8th day at 10mg. Is this normal?

[panic_down_under]

So today was pretty awful. Anxiety and headaches all day long. Spent most of the day on the couch. Took 2mg Valium before dinner.

Yesterday I actually had a good day and was quite productive so I was hopeful that I was turning a corner.

I think it is my 8th day at 10mg. Is this normal?

At this early stage escitalopram won't be having a positive impact even factoring in whatever residual benefit may have accumulated from the small paroxetine dose, but, as with all ADs at the beginning, it could be making anxiety worse because of the increased serotonin activity. It is early days so I wouldn't read too much into it, or the better previous day, John.

[Balt]

I'm on day 7 of this journey. I'm on it for GAD, at the moment I'm super stressed about my bowels so trying to determine if it's the drug that's making them weird or something else. Other than that I can feel kinda spacey at times. Hope it kicks in soon !

Good luck!

[jonjon]

Thankfully I have not had any trouble in the bowel department.

However I can say that I officially feel worse now than when I started. Killer headaches, jaw clenching, anxiety much worse and no attention span.

Just feel like lying down on the couch all day. Forcing myself to go for a walk now with my clenched jaw.

[panic_down_under]

at the moment I'm super stressed about my bowels so trying to determine if it's the drug that's making them weird or something else.

Serotonergic ADs can trigger a range of bowel issues at the beginning including diarrhoea and/or constipation. The gut is by far the most serotonergic organ of the body, making about 50 times as much serotonin as the brain. The brain is only a minor player making and using less then 2% of the body's total.

The gut is controlled by its own mini brain, the enteric nervous system (ENS), which is replete with serotonin receptors which can be as affected by ADs as those of the brain. The ENS is is also a significant force in manifesting anxiety and depression. It is directly linked to the brain via the vagus nerves and seems to be the more dominant partner with most of the data flow originating from it (it is also connected to the heart and lungs via the vagus which allows it to trigger anxiety symptoms such as rapid pulse and shortness of breath in addition to gut related anxiety symptoms). It is arguably the tail wagging the brain 'dog'. Electronic vagus nerve stimulators which inhibit the ability of the gut to communicate with the brain have proven to be effective for treatment resistant depression, though much less so for anxiety disorders.

In turn the ENS is influenced by the gut microbiome. How you feel emotionally can literally be effected by your poop! Gut microbes also have binding sites (receptors) targetted by ADs so may also be affected by them. In addition to their direct impact on the ENS, there is also evidence that ADs can alter the mix of gut flora. All of which makes a strong argument for us being merely the life support system for the bugs in our guts who can lead us on a merry chase at times. They outnumber the cells of our bodies by about 10:1 so we don't stand a chance if they turn on us!

See also:

Gut microbiota plays a role in brain function and mood regulation (Article | Study)

How your gut might modify your mind

Gut bacteria, the vagus nerve and the brain (PDF)

Gut bacteria and the brain: Are we controlled by microbes?

Gut communicates with the entire brain through cross-talking neurons

Gut microbes may talk to the brain through cortisol

Nutrition and mental health: Is there a link?

What bowel issues do you have?

[panic_down_under]

However I can say that I officially feel worse now than when I started. Killer headaches, jaw clenching, anxiety much worse and no attention span.

Unfortunately, these are fairly typical initial SSRI side-effects. All you can do is treat the symptoms until the body adjusts.

Just feel like lying down on the couch all day.

If that is what you need to do to get through another day then so be it, though doing things which distract you from what you're feeling will help.

[Balt]

What bowel issues do you have?

Don't want to hijack the thread but I've posted in the IBS/bowel forums.

Thanks for the write up, very informative!

[jonjon]

All good Balt. We are all here to help each other.

So I am at day 13 on 10mg and all symptoms still persist as before.

Last night I was so stirred up I took 0.25mg clonazepam.

Psychologically I feel very nervous as I have to go into work pretty much everyday next week.

Probably still have a long way to go till I feel any relief.